When Botox first gained FDA approval for cosmetic use in 2002, it was primarily used by women in their 40s and 50s.
Now, women in their twenties are getting ‘baby Botox,’ or smaller amounts for more subtle results, as a preventative way to prevent aging.
But can getting Botox too frequently lead to becoming immune to the treatment?
Women flock to social media to figure out the next steps if they fear they’ve become immune, questioning why it seemingly stopped working and seeking answers – especially if they’re spending hundreds of dollars on a treatment that doesn’t seem to be doing the trick.
They blame everything from Covid vaccines to switching to a different injectable, like Daxxify or Xeomin, or start trying fillers instead.
Theories include building up antibodies against it after repeated use to metabolizing it more quickly from frequent hardcore workouts.
Sometimes people aren’t actually immune, but the neurotoxin is just wearing off more quickly because of surprising factors, including intense stress.
DailyMail.com spoke to experts about how a number of women are becoming resistant to the tweakment, and how they can prevent it.
When Botox first gained FDA approval for cosmetic use in 2002, it was primarily used by women in their 40s and 50s

Can getting constant Botox lead to becoming immune to the treatment? And more importantly, what can prevent that from happening? (stock image)
New York City-based plastic surgeon Dr. Brian Bassiri-Tehrani explained that patients don’t become immune and develop antibodies – instead, they just become resistant.
It’s at risk of happening ‘the more often you’re exposed to the product in higher doses,’ Dr. Bassiri-Tehrani explained from his luxurious Upper East Side office.

Dr. Brian Bassiri-Tehrani explained that patients don’t become immune and develop antibodies – instead, they just become resistant
‘People who will dose or touch up Botox in between the regular three month sessions might be at risk.’
‘Another thing that people don’t fully realize about Botox is that once it goes into the neuromuscular junction it binds to the nerve endings that are powering the muscle, and it doesn’t just come off in three months, and everything’s fine,’ Dr. Bassiri-Tehrani said.
‘It permanently attaches to those nerve endings, and what happens is new nerve endings go into the muscles,’ the surgeon continued.
‘So the reason it wears off in three months isn’t because the Botox disappears. It’s because new nerve endings are now innervating those muscle units, and when they reinnervate the muscle units, they’re not reinnervating the exact same muscle units exactly the same way.’
Dr. Brian Bassiri-Tehrani suggests waiting every six months for new nerve endings to fully take root and heal.
Lisa Chevalier, the founder of SoVous Medical Spa, has been injecting Botox for 17 years on many of the same patients. The Manhattanite has seen ‘a small number of patients who get higher doses that have built a resistance to Botox and over time also to other neuromodulators.’

Dr. Brian Bassiri-Tehrani suggests waiting every six months for new nerve endings to fully take root and heal before getting Botox again (stock image)
Lisa has had patients come in and tell her they’re ‘immune’ to Botox or that ‘it just doesn’t work well for them when it previously did.’ She then finds out they’ve visited multiple practices and weren’t sure if they had Botox or another similar substance.
‘Botox is the household name of neuromodulators like Kleenex and in advertising and discussion practitioners often refer to it because it’s just what people know, when in reality the patient is consented for and injected with a sister product,’ Lisa explained.

Lisa Chevalier, the founder of SoVous Medical Spa, has been injecting Botox for 17 years
‘If the product is improperly handled or diluted, it may be less effective, leading to the false impression of resistance,’ Lisa warned.
It also depends on whether the practitioner you’re visiting is sketchy. ‘Some practices may charge by area and essentially give clients subclinical doses because it falls in line with their pricing,’ Lisa said.
Lisa said to look for practices that instead charge by unit, which tend to be more fair and transparent.
Lisa has seen true Botox immunity only twice in her 17 years of practicing, which leads to trying another product.
Many women can become so obsessed with the effects that they want to come back too often which can lead to resistance.
If someone starts Botox young preventatively, Lisa suggests spacing between treatments to avoid resistance.
Lisa advised that people who are worried about resistance can rotate brands, avoid excessive doses by sticking to the lowest effective amount, and space out treatments appropriately.

Facialist Jade Haifa told DailyMail.com that throughout her career she’s ‘had clients who over time developed immunity to Botox’
Many people think they’ve become immune to Botox when their results are just wearing off faster.
Real Botox resistance, where the body produces antibodies to neutralize it, is far more rare.
Factors that break down the longevity of neuromodulator treatments include a faster metabolism, working out intensely, smoking, drinking alcohol, workout frequency, sun exposure and high stress.
Facialist Jade Haifa Oueslati, based in New York City, told DailyMail.com that throughout her career she’s ‘had clients who, over time, developed immunity to Botox and as a result sought alternative facial treatments to achieve similar outcomes.’
While ‘these treatments do not directly replace Botox, they can provide comparable benefits such as skin tightening, wrinkle reduction, and overall facial rejuvenation.’
Jade, who boasts a whole slew of models and influencers as clients, suggests microneedling, which stimulates the production of collagen and elastin, microcurrent, which works by exercising and strengthening the facial muscles, and buccal facials, which use deep muscle relaxation, sculpting, and circulation to deliver a subtle rejuvenating effect.
Jade also recommends using retinoids, which accelerate skin turnover, Vitamin C to protect the skin from oxidative stress and Peptides to help strengthen the skin’s structure.
‘While immunity to Botox is rare, it can occur under specific circumstances, such as with repeated high doses of Botox that may trigger the development of antibodies, genetic predispositions, or certain medical conditions,’ the skincare expert confirmed.